Individual provider Active NPI

Noelle Mortensen Haines, A.P.R.N FNP-BC

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1285214205
Registry record updated Jul 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
10216868-4405 Issued in UT
Practice address
2796 S 2000 E
Salt Lake City, UT 84109-1737
Phone
(301) 693-7830
NPI assigned
Apr 13, 2021
Last updated
Jul 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 10216868-4405 UT Primary

Addresses

Primary practice location

2796 S 2000 E
Salt Lake City, UT 84109-1737

Mailing address

12433 S Fort St
Draper, UT 84020-9363
Phone (801) 576-1086

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231107001104 UT Practitioner - Nurse Practitioner 9234586637 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
10216868-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Amazing Medical Associates, Inc CurrentSince Sep 25, 2023 Accepting new patients
Patients Choice Providers of Utah LLC CurrentSince Jun 1, 2024 Accepting new patients
Pioneer Injury Care Past Accepting new patients
Pioneer Comprehensive Medical LLC Family PastSince Jan 2, 2001 Accepting new patients

Locations

434 W Ascension Way
Ste 225
Salt Lake City, UT 84123
Phone (801) 716-7008

Interoperability endpoints

  • Direct secure messaging: noelle.haines@736943059828740.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1285214205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12433 S FORT ST",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840209363",
            "telephone_number": "801-576-1086",
            "fax_number": "801-576-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 S 2000 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091737",
            "telephone_number": "301-693-7830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINES",
        "first_name": "NOELLE",
        "middle_name": "MORTENSEN",
        "credential": "A.P.R.N FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-13",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10216868-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.